In this paper, the author explores the clinical ethical issue of the withdrawal and withholding of life-prolonging treatment, surveying 2,848 lawyers and 2,469 doctors as medical and legal professionals in Japan on a variety of points for discussion. The main survey items are: (1) systems that should be used in the withdrawal and withholding of life-prolonging treatment at the end of life; (2) problems in determining treatment strategy at the end of life; (3) assessment of suspension of life support systems (extubation); and (4) strategies for better end-of-life care. While 42.2% of lawyers cited legislature and judiciary and 54.9% cited academic society guidelines as the system that should respond to the withdrawal and withholding of life-prolonging treatment, 23.3% of doctors cited the legislature and the judiciary, and 65.4% academic society guidelines. In relation to current end-of-life care, 81.3% of lawyers and 69.3% of doctors responded that there was room for improvement. Strategies for doing so included ensuring the transparency of and publishing decision procedures, and notification to government. It is important for medical institutions to normalize end-of-life care by making decisions with reference to guidelines and the like, ensuring the transparency of decision-making procedures, and being managed by a public institution.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971036 | PMC |
| http://dx.doi.org/10.18999/nagjms.84.1.139 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Survival outcomes of apalutamide as a starting treatment: impact in real-world patients with metastatic hormone sensitive prostate cancer (OASIS).
Prostate Cancer Prostatic Dis
December 2024
Advent Health Urology Denver, 850 Harvard Avenue, Denver, CO, 80210, USA.
Background: Androgen receptor pathway inhibitors (apalutamide [APA], enzalutamide [ENZ], abiraterone acetate plus prednisone [AAP]) combined with androgen-deprivation therapy (ADT) are effective life-prolonging treatment options for metastatic hormone-sensitive prostate cancer (mHSPC). We evaluated the impact of upfront therapy for mHSPC on outcomes in real-world clinical practice in the United States.
Methods: This retrospective, observational cohort study used electronic healthcare records from the ConcertAI RWD 360 Prostate Cancer Dataset.
Improved prognosis of de novo metastatic prostate cancer after an introduction of life-prolonging agents for castration-resistant prostate cancer.
Int J Clin Oncol
December 2024
Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Background: In Japan, since 2014, new treatments such as androgen receptor signaling inhibitors and cabazitaxel have become applicable for metastatic castration-resistant prostate cancer (mCRPC), leading to dramatic changes in treatment options.
Objective: This study aims to evaluate the impact of recent advancements in treatment options on the overall survival (OS) of patients diagnosed with de novo metastatic castration-sensitive prostate cancer (mCSPC) in Japan.
Methods: A retrospective analysis was conducted on 2450 Japanese men diagnosed with de novo mCSPC between 2008 and 2018.
Ethical Decision-Making Regarding Life Sustaining Treatment in End-Of-Life Care: A Scoping Review of the Similarities and Differences Between Two Viewpoints.
Arch Acad Emerg Med
November 2024
Department of Obstetrics and Gynecology, School of Medicine, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Decisions on life-sustaining treatment depend on evaluating fundamental ethical principles regarding taking human life. This study aimed to compare the Islamic standpoint with secular views on ethical decision-making in end-of-life care. We conducted a scoping review to analyze and compare articles published in 2000-2022, regarding ethical criteria for withdrawing life-prolonging treatments in dying patients, and the final decision-maker in such cases.
View Article and Find Full Text PDFTime's up: the urgency to investigate time toxicity in patients with genitourinary malignancies.
Ther Adv Med Oncol
December 2024
Dana-Farber Cancer Institute, Boston, MA, USA.
Patients with genitourinary (GU) malignancies have seen the development of multiple life-prolonging treatments in the past decade. As patients and clinicians consider their treatment options along the cancer journey, time spent with healthcare contact, or "time toxicity," has emerged as a new outcome measure that comprehensively considers time receiving cancer care, including planned visits for evaluation and treatment as well as unplanned urgent care addressing complications. Despite its rising study across cancer populations, there has been a surprising lack of work evaluating time toxicity in patients with GU cancers.
View Article and Find Full Text PDFCancer treatments, although life prolonging, are associated with side effects. The occurrence, duration, and severity of side effects vary, depending on treatment received. Long-term effects refer to effects that manifest during treatment and persist long after treatment has ended.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!